Ensuring a patient escort has long been a standard safety requirement for discharge after outpatient anesthesia. The rule is increasingly difficult to satisfy for patients who live alone. Even when a loner patient can arrange for someone to closely oversee them at home until the effects of anesthesia have completely worn off, which is generally presumed to be a 24-hour period after administration, they cannot always ensure someone to physically accompany them from the outpatient facility.
The intent of the escort rule is twofold. First, it ensures that post-anesthesia outpatients remain closely overseen until their mental status has adequately returned to baseline and they can once again self-recognize any safety concerns arising within them. Second, it allays provider liability concerns, given that post-anesthesia and post-procedure events can go unrecognized when an outpatient is recovering alone and unaccompanied at the place of post-anesthesia boarding.
A human overseer at the place of boarding has not yet been replaced by anything artificially intelligent. The transportation leg of that chain, however, can be. Waymo Drivers have already arrived in many cities and are arriving soon in many more. Perioperative teams should therefore consider, and explore collaborating on, an artificially intelligent escort program through which monitored patients can safely reach their place of post-anesthesia boarding to meet the human overseer who will then watch them until the anesthetic has fully worn off.
The mechanism is straightforward. Waymo Drivers, with real-time non-stop access through their interior cameras, could provide immediate and timely live audio-video remote support, ensuring that a discharged outpatient remains under monitored conditions continuously until handed over to the human overseer at the doorstep of the place of post-anesthesia boarding.
The same channel handles emergencies en route. A Waymo Driver could responsibly return the monitored outpatient to the outpatient facility, or redirect the route to the emergency department, unless the patient’s condition is catastrophic enough to warrant immediate dispatch of EMS, in which case the Waymo Driver could hold the ground until emergency medical responders arrive. If legally permitted, the Waymo Driver could even continue to keep the outpatient inside its enclosed monitored conditions until the contacted human overseer reaches the doorstep of the boarding place to receive them.
If such an artificially intelligent escort program were ultimately deemed safe and acceptable, Waymo Drivers could potentially obviate the need for any human escort accompanying any outpatient, loner or not, presenting for outpatient anesthesia, as long as a human overseer is confirmed to receive them at the doorstep of the place of post-anesthesia boarding. The human overseer, too, could one day be replaced by an artificially intelligent overseer program, futuristically bestowing total independence on humans, and especially loners, scheduled to receive anesthesia for outpatient procedures and recover thereafter on their own. Mandated post-anesthesia human monitoring would then become redundant, called in only when an unexpected, unsafe turn of AI-monitored events warrants human contact for such totally independent loner patients.
Deepak Gupta is an anesthesiologist.
